Ross Millar
China is a bit of a hot topic at the moment. This is no more so than the reform of its healthcare system with a variety of perspectives being put forward about the successes and missed opportunities associated with the progress made to date. [1] [2]
Over the past few years a group of us at HSMC have been increasingly interested in the Chinese experience, particularly in how some its policy proposals have translated across a diverse, dynamic and increasingly powerful society. Building on previous HSMC visits, I secured some funding from the British Academy to go with Robin Miller and Russell Mannion to visit colleagues at the Peking University Health Science Centre in Beijing. The aim was to explore the possibility of developing further links between the centres with a variety meetings and seminars being held to exchange views about the key issues both systems were currently facing.
In addition, a key part of our recent visit was to gain insight into how the Chinese system worked. I suggested this to colleagues at Peking and they proposed that a visit to the local hospital might be a good idea. We gladly accepted this offer and following our first meeting we were taken to their university hospital – the Third Hospital - by two health policy and management MSc students.
As with our local hospital – University Hospitals Birmingham Foundation Trust – the Third Hospital was only a short walk from the campus. As we walked towards the back entrance of the hospital my initial reaction was fairly underwhelming. In many ways it looked like a fairly run of the mill 1970s/1980s district general hospital building we have here. Yet as we got closer this impression started to change. When I turned the corner and approached the front entrance I began to see something different: a modern hospital covered with large panes of glass and a rolling electronic screen above the entrance – a bit like those rolling signs giving the latest market figures you see on Wall Street.
We went inside and I was impressed – Robin suggested that it felt like the entrance to a train station. I agreed, it did resemble something like Grand Central station but I thought there was something else – it felt more commercial, something like the entrance to a shopping mall with its large tiled floor, elevators, and information points.
When walking through the Third Hospital it felt calm and relatively quiet. Compared to the well documented pressures on NHS hospital services this was some achievement! However our student guides were quick to inform us that the hospital was not usually like this. If we visited the hospital in the morning (rather than 3pm) we would see something quite different – long queues, high demand and the day to day chaos of a university hospital! In what felt quite similar to our experience in the NHS, our guides described how escalating hospital demand and the struggle to move care into primary and community settings were the key issues currently being faced.
The Third Hospital was two years old and this was probably the key thing that struck more than anything else – it was modern and appeared relatively advanced. I was intrigued that on visiting the entrance to A&E there was equipment for patients to carry out their own blood pressure test with the results being automatically sent to the relevant parts of the hospital. I was also impressed with the amount of information and signposting for patients. Either side of the entrance were standard reception points but what also struck was the number of standalone information booths. They looked a bit like the machines you see at job centres but these did a lot more than be mere directories. The machines provided access to patient records (password protected), further information about particular conditions, and opportunities to order and arrange prescriptions. In addition to the booths, plasma screens were dotted around on pretty much every pillar with information and updates popping up regularly.
Overall, our visit to the Third Hospital was a real privilege. I never actually found out why it was called the Third Hospital but the visit did leave me with a number of questions about the NHS - particularly how we could further facilitate patient self-management and improve the information we provide for both patients and the public. I am truly grateful to our student guides and to the Peking Health Sciences Centre.
Notes
[1] http://www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/HSMC/publications/Newsletters/newsletter-volume19-no2.pdf
[2] China crisis? - Professor Mark Exworthy writes a ViewPoint piece about the health care system in China